I know you're not supposed to laugh:
Interesting approach to the C-collar and backboard.
A little better now
Monday-morning q-backing: With that mechanism of injury and the altered mentation, I probably would have restricted spinal motion with immediate c-spine traction and c-collar and backboard asap. It seemed like the responders took a long time to get to that point - the patient's unrestricted movement might have aggravated a possible c-spine injury.
You can't rule out c-spine injury just because of consciousness (even assuming there wasn't a positive loss of consciousness), and the altered mentation indicate any patient's denial of numbness or tingling may not be reliable. The video doesn't show any palpation of the patient, so that info's not available.
Taking pictures/video like that likely violates patient privacy, especially considering altered mentation (no patent consent).
/Monday morning q-backing.
Found this thread through my Youtube and thought I'd chime in... I'm the one in the video with the concussion. It happened in the backcountry not on Alta Ski Resort. We had built a jump in Grizzly Gulch, and the Alta Ski Patrol coincidentally happen to be skiing by just seconds after I slammed my face into my ski pole. I don't know why they happened to be over there since it is on the opposite side of the canyon road, but I'm glad they were there to assist.
Whipit, thanks for replying. Hope you healed up nicely from your freestyle moves.
I believe that Alta does some snowcat skiing up in GG and that is one possible reason they were skiing by.
In cases of a consciousness and a LOC of < 4x4 you need to perform a pretty full assessment and take the more conservative approach to stabilization and transport. Closed head injuries are nothing to F%^k around with.
I wasn't there, it appeared to be a nice enough day with a relaxed scene and eventually the patrollers got to the point of applying proper C-spine protection.
Perhaps Whipit can add some more context.
That said, any medic is crazy to allow filming of a patient while they are working on them.
I never cease to be astounded by what you can find on You-tube.
Thanks for the welcome and good wishes. This actually happened in 2005. I ended up tearing my left ACL and getting a few stitches but beyond that I was fine. At the time my bro-in-law was always filming and making ski vids. Apparently Alta Patrol didn't mind. I don't know if things have changed since then.
To answer the question: it depends. The factors include the ski area's protocols, the level of licensure/capability/ability of the responders, the assessment (primary and secondary), the mechanism of injury, presence or lack of multiple injuries, the patient's history and input, any transportation issues, etc.
Emphasizing that most of us weren't there and that we're just reacting to an edited, it's curious that they treated the laceration, then initiated spinal motion restriction procedures afterwards, but it's possible that there was some development or issue or protocol or factor that we don't know about that influenced the decision. But I know that my patrol director would have some questions for me if I were one of the responders (as we saw with Bunion's response).
As for filming, it can violate the patient's right to privacy as well as lead to harsh questions from patrol directors.
I find this a very interesting question.
As more and more video cameras become easier to use in these environments, it's no secret that more people will try to film rescue efforts. If patrol directors don't already have a policy on this, they probably need to put one in place very quickly.
Filming first responders is a really, really slippery slope (sorry, couldn't resist). Bob, how would you handle this if you came up to a wreck - particularly one with at least the possibility of spinal or cranial injuries - and somebody was standing there filming your every move? You probably can't very well ORDER the guy to stop filming, but there's a big can of worms that is potentially being opened up. Ski injuries in particular are so often very nebulous. You've got cold weather, tons of clothing, and possible joint injuries that are often difficult to diagnose even when the patient is lying naked in the hospital after an MRI. It just seems to completely open up first responders to lawyer second-guessing when there's a film version of everything they did (and didn't do).
And THIS case becomes even more interesting because the patrollers weren't even responding to an inbounds accident. They were more like Good Samaritans or SAR than official patrollers.
Whipit, I'm sorry about your knee but glad you didn't have anything worse. Thanks for joining in.
The victim has posted in this thread. The video was taken by his brother-in-law and - presumably - put on YouTube by either the victim or the brother-in-law.
Doesn't HIPAA only apply to health care providers and professionals giving out information without the patient's permission?
I can't see why Epic would delete the link. Who's been harmed here?
The victim posted after the video had been up for a while. I wonder how he felt when he saw himself in that shape for the whole world to see.
Are you sure the victim really posted this on Youtube? Is that where you found it? If so then the victim has every right to broadcast this. But at least in this forum, he wasn't the one broadcasting it.
I think that if he doesn't want it posted here, it would be a really nice gesture for Epic to remove it.
And yes HIPAA applies to health care providers. Are Ski Patrol in this category? Even if they're not legally bound by HIPAA, it seems that for all practical purposes they're working as Health care providers. So if a patroller made the video, then it's release would be a privacy violation.
If his brother made the video and put it up on Youtube then I agree there's no violation.
Since the patrollers are providing professional medical care, they could not post this video. A brother-in-law can.
As far as barring filming, how would that go? The patrollers can ask...even demand...that a bystander not film them, but what if said bystander refuses?
I can just about guarantee the patrollers wouldn't be able to use force to stop him, so then what? Hell, law enforcement officers typically can't even do that.
A right to privacy claim would be a stretch, since he's in a location where there's generally no expectation of privacy...except for HIPAA restrictions on medical responders, of course.
Like I said earlier, This video was taken Feb 12th, 2005. It, along with countless other clips that my bro-in-law took, have been on my computer for years. I've just recently started posing them on Youtube for entertainment. And I am the victim, so it was no surprise to me to see my concussion on youtube or any other site because I was the one that put it on youtube as a public video in the 1st place. I appreciate the discussion and controversy it has caused. Hopefully, in addition to being entertaining, it can in some way be educational.